Day 36

I'm still in the hospital - G11, the transplant floor. As it turns out the cause of the fever is likely a small outbreak of the cytomegalovirus, CMV for short. They measure this in terms of the number of actively infected cells in a million white cells. They treat if the CMV count is 3. That's right, 3 in a million. My count was 6 on Tuesday and 10 yesterday.

CMV is a common herpes virus that 80% of the population has. It activates in people with compromised immune systems like leukemia and HIV patients. When your T-cell count goes below 100, CMV can become active. In HIV patients they worry about an eye disease called CMV retinitis and in leukemia and bone marrow transplant patients they worry about pneumonia. CMV can cause a form of pneumonia that has a 35% mortality rate. I guess that's why they get excited about a count of 3.

I still got my scans done this week. They tried to wheel me down to the 3rd floor, but I refused to go in a wheel chair. So the transportation assistant (yes, they have a transportation department) walked pushing an empty wheel chair and I followed along behind walking and pulling my IV tree. The PET scan was done on Wednesday on the third floor, and the CT scan was done yesterday. They also did the BMA (bone marrow aspiration) Wednesday afternoon in my room. So I should still be able to get an idea of how I'm doing by next week.

I might be able to get of the hospital tomorrow if the CMV test that is being run today comes back with a count of 10 or less and my temperature remains normal. The nursing assistant recorded my temperature last night at midnight incorrectly, which didn't do my chances of getting out today any good. My temp for the last 24 hours + has been 37.0 or less (centigrade). 37.0 C is 98.6 F. She recorded it as 37.5 instead of the 36.5 that I remember. But with the CMV count increasing I wasn't getting out today anyway. Nevertheless, I now have my own record posted in the room which they will have to initial. When the CMV count drops I am not letting an incorrect temperature recording keep me here.

As an in-patient I didn't have to sit in the waiting room on the 3rd floor for my PET and CT scans. They just walked me through a back entrance into a large staging and recovery area to wait my turn. As an out-patient you don't even know that this recovery area exists. But as I was sitting there in my curtain cubicle #19 it sort of got to me how many people go through this one area. There are several areas similar to this in other parts of this building and the new building across the street. Most patients who came in were in a bed or wheel chair. Those in a bed were out of it and most of those in a wheelchair were partially out of it. I never really thought about it until then, but cancer patients seem to be able to put their chin on their chest and sleep while sitting up. Most normal people would have a hard time just trying to touch their chin to their chest. That made me think about Steve S. from church who was suffering from brain cancer but nevertheless went on the church ski trip to Colorado the winter before he passed away. He slept on the bus with his chin on his chest as we drove through the mountains. I don't know if this is some form of resignation or not. Yesterday there was gentleman across the "hall" in curtain cubicle #15 who was, I thought, asleep in his wheel chair. A nurse came to find him and was calling his name, Mr. Tunstall, I believe. He didn't respond to her "Mr. Tunstall, Mr. Tunstall, Mr. Tunstall." So she started patting him on the shoulder and saying "Mr. Tunstall, Mr. Tunstall, Mr. Tunstall. Open your eyes, Mr. Tunstall. Open your eyes." Finally, and without lifting his head off his chin, he growled "My eyes arrrre open."

I don't know why I told you about that except to highlight how pitiful many of these cases are. It's even more heart wrenching when you see children going through this. Many people need prayers every day. Mr. Tunstall will be in mine.

I hope I never fall asleep with my chin on my chest again.